BY DON SLESNICK

DONSLESNICK@CORALGABLES.COM

When aid reaches countries in need, the potential for bad policy and short sightedness exists to the detriment of those we are trying to help. This was evident during my recent trip to Haiti.

To ensure that people would not go hungry, the United States set up a system to distribute U.S.-grown rice to Haitian families. We were saddened to see rice bags travel no more than 20 yards from the gates of the distribution site before ending up in the back of a pickup truck presumably headed for the black market.

To our further dismay, we returned home to read news stories that those very same donations were undercutting Haitian rice farmers who needed income to support their own families. Our system is giving with one hand, but taking with the other. Were it not for the presence of the U.S. military, there would have been little organization and coordination within the relief operation.

My recent mission to an orphanage in Haiti was revealing on a range issues, from human-rights and disaster relief to the impact (or lack thereof) of U.S. foreign aid on the depressed quality of life within third world nations.

When the horrific earthquake struck Haiti in January, citizens from across our land offered physical and financial support for relief efforts to assist the Haitian people through the height of the crisis.

However, getting that assistance to the people who need it can be a challenge because of the complex bureaucracy that governs how aid is distributed. Research by credible and respected relief organizations, such as Oxfam America, can attest that navigating the tangle of government red tape (which currently chokes our current federal foreign-aid system) can slow the relief process to an ineffective crawl.

Simply put, our foreign-aid system is broken. The results of this breakdown are great waste and numerous inefficiencies. Within the federal government some 12 departments, 25 agencies, and 60 offices are involved in foreign-aid distribution, with very little coordination and no effective “chain of command.” Foreign-aid legislation now totals 38 major laws that contain 140 priorities and 400 directives. The rules, regulations and underlying legislative acts are, in many instances, incomprehensible and do not properly inform aid workers as to the exact nature of their mission or the manner in which it should be accomplished.

As thousands of Haitian earthquake survivors, many of whom are still living under tarps in flood zones, prepare themselves for what the National Oceanic and Atmospheric Administration is predicting as one of the severest hurricane seasons on record, it is imperative to reform our aid system and find a better long-term approach.

Crafting a clear, modern strategy and framework for our foreign-aid system can reduce such contradictions in our efforts to help the poor. A better system will result in more of the aid getting through to effectively address local needs in a meaningful manner.

The underlying laws regulating the foreign-aid process were enacted 50 years ago and have been reworked and amended so many times on an ad-hoc basis that interpreting them is just as complex as trying to figure out who is in charge of what. Is it any wonder that so few of the taxpayer dollars dedicated to foreign aid actually make it to the people they’re supposed to help?

An overhaul of the nation’s approach to foreign aid is not only good for efficient philanthropy, it’s good for world stability and it’s good for local business. A 21st-century system of foreign aid would truly help struggling nations within our hemisphere help their people have a more abundant life and would lay a better foundation for their commercial institutions.

Both results would add to the health and vitality of our community and would create more stable trading relationships for South Florida. In turn, the stronger our economy becomes, the greater our ability becomes to increase our assistance to other countries. The goal, of course, is that this productive cycle will continue to benefit everyone at both ends of the spectrum. This is truly a vision we should nurture and support.

Don Slesnick is the mayor of the city of Coral Gables.

Read more: http://www.miamiherald.com/2010/06/09/1670457/foreign-aid-policies-hinder-recovery.html#ixzz0rVi9KLWY

by Jeff Jacoby

The Boston Globe
June 16, 2010

http://www.jeffjacoby.com/7618/in-love-with-socialized-medicine

PRESIDENT BARACK OBAMA was adamant: His health-care overhaul would not put Americans on the road to British-style, government-run medicine. Speaking to the American Medical Association last June, the president dismissed as “scare tactics and fear-mongering” all talk of “socialized medicine and government takeovers; long lines and rationed care; decisions made by bureaucrats and not doctors.” A few weeks later he reiterated the message: “I don’t believe that government can or should run health care.”

“I am romantic about the (British) National Health Service. I love it.” — Dr. Donald Berwick, President Obama’s choice for director of the Center of Medicare and Medicaid Services.

But if Obama is as firmly opposed to a government-ruled health sector as he claims, why has he nominated as administrator of Medicare and Medicaid — far and away the nation’s largest health-insurance programs, covering one out of every three Americans at a cost of nearly $1 trillion — a man who openly adores Britain’s socialized health care?

“I am romantic about the National Health Service,” Dr. Donald Berwick, the president’s pick for director of the Center for Medicare and Medicaid Services, told a British audience in 2008. “I love it.” Not only does he love the NHS, he extols it as “an example for the whole world — an example … that the United States needs now.”

From all accounts, Berwick, a pediatrician, is respected by his peers. He is the founder of the Cambridge-based Institute for Healthcare Improvement, and an expert on making patient care safer and more efficient. Among his supporters are Bill Frist, a physician and former US Senate majority leader, and several previous directors of the Center for Medicare and Medicaid Services.

But if Berwick’s credentials cannot be doubted, neither can his ideological commitment to centralized state power over health care, or his disdain for the ability of markets and competition to improve the quality and lower the cost of medical services.

He has publicly saluted Britain’s socialized National Health Service for rejecting the “immoral” American system and “the darkness of private enterprise.” He declares that “the Holy Grail of universal coverage” cannot be achieved with consumer-centered health care, but only through “collective action overriding some individual self-interest.”

And he embraces health-care rationing. “The decision is not whether or not we will ration care,” he said in a 2009 interview, “the decision is whether we will ration with our eyes open.” This is a view Berwick has held for a long time; more than 10 years ago he wrote that “limited resources require decisions about who will have access to care and the extent of their coverage.” Accordingly, he praises the NHS for “making tough choices” about the care it administers — unlike the American system, in which the supply of medical care is not artificially restricted. “Here, you choose a harder path,” he said in Britain two years ago. “You plan the supply; you aim a bit low; you prefer slightly too little of a technology or a service to too much; then you search for care bottlenecks and try to relieve them.”

But those who have to live with the NHS and its “bottlenecks” don’t always find them quite so admirable. For months, the British press has been reporting horror stories about the realities of government-run health care. Some recent headlines give a sense of the coverage:

“Overstretched maternity units mean mothers face a 100-mile journey to have baby.”

“Hundreds of patients died needlessly at NHS hospital due to appalling care.”

“Cash-strapped NHS trust introduces rationing for common children’s conditions.”

“Standard of care in some wards ‘would shame a third world country.’”

“Stafford Hospital caused ‘unimaginable suffering.’”

No one would deny that America’s health care system is flawed in many ways. But when it comes to the standard that matters most — the quality of health care provided — our haphazard, expensive, insurance-based system towers above the NHS.

“In Britain 36 per cent of patients have to wait more than four months for non-emergency surgery,” wrote journalist James Bartholomew in The Spectator. “In the US, a mere 5 per cent do.” By one metric after another — cancer survival rates, performance of diagnostic tests, availability of CT and MRI scanners, consultation with specialists — US health care is superior. “British state-run healthcare,” Bartholomew concluded, “is so amazingly, achingly, miserably, and mortally incompetent.”

That’s the system that leaves Berwick feeling “romantic” — the system he proclaims an “example” for the United States. And Obama wants him to run Medicare and Medicaid? Let us hope at least 51 senators say no.

(Jeff Jacoby is a columnist for The Boston Globe).